Notes on mental health and neoliberalism

I recently read a couple of Foucault’s later lectures, namely Security, Territory, Population (1977-1978) and The Birth of Biopolitics (1978-1979). In this latter set of lectures, Foucault made a rare foray into contemporary economics, analysing various currents of neoliberalism (especially German and US varieties) and their relation to new forms of governmentality. I thought it beneficial, if only for me, to jot down a few notes on Foucault’s reconstruction of neoliberal thought, because I think it particularly pertinent in understanding contemporary knowledge and practice in mental health. I have a paper forthcoming in an academic journal on this topic, and perhaps after this post, I can move onto other things in 2016.

Of ‘Psychopathic’ Children & Interventionist Clinicians

Researchers in New South Wales are on the hunt for ‘psychopathic’ pre-schoolers. Apparently, they have created a ‘diagnostic tool’ in which young children are shown images, either ‘distressing’ or ‘neutral’, in order to classify the child as either ‘healthy’ or ‘callous’ on the basis of their responses. The 10% of children who were found to be ‘unemotional’ can be targeted for early intervention.

The Leftist Defense of Psychiatry

This article raises some typical points in service of a leftist defense of psychiatry. (NB: the post I am citing summarises rather than advocates for these positions). This defense hinges on the claim that if mental illness is held to be ‘socially constructed’, this conception may lead to a denial of the existence of certain forms of suffering. This denial is something that can then be exploited by contemporary governments increasingly eager to implement spending cuts and austerity measures. One person cited in the article was Tad Tietze, for whom ‘the logic of Szasz would empty hospitals and put the same people in prison’.

Longer Chains and Bigger Cages

A reply to Peter Kinderman:

 

For me, a psychologist is bound to run into problems if s/he wishes to jump paradigms without proper consideration of epistemology, or if s/he wishes to consider the ethics of forensic intervention whilst completely ignoring Foucault (among others). This article exemplifies such an approach.

Paradigm Shifts after the Decline of the Medical Model

‘Neuroenhancement’ in its various forms, whether applied to cognitive tasks, or social functioning, looks initially like one more medical intervention. This, however, is misleading. For all of its flaws, the medical model is relatively simple and static. The idea is to identify pathology or malfunction, and to remedy it. Where the pathology in question is a positive symptom or syndrome, medical intervention is relatively free of controversy.

Reductio ad traumatum

In 1933, two servant girls in Le Mans, France, Christine and Léa Papin, murdered two of their employers.(1) Madame Lancelin and her adult daughter were bludgeoned and knived repeatedly, to the point of unrecognisability. Each had their eyes gouged out. The Papin sisters had spent much of their young lives in institutional care. Their family had a history of incestuous abuse, and at least one of their relatives had died by suicide.

Love, technology, ideology and ethics: A critique of “neuroenhancement”.

“The medicalization of love”[1] is one of a series of papers[2][3] in which Earp, Savulescu and others explore the ethical ramifications of administering neurochemical interventions to address problems of love. The authors rightly observe that love is, in many ways, already ‘medicalized’, and anticipate some ethical objections to neurochemical interventions in human relationships. Specifically, the authors reject charges of neural reductionism, and disagree that neurochemical interventions need necessarily increase “pathologization” and the expansion of medical-social control. I wish to argue that these conclusions are, from many points of view, misleading, to say the least.

A Note on Psychometrics: A Critique of CBT as Ideology (Part 4)

As a final word on epistemology, it is worth noting that the prop which keeps CBT concepts upright, and which supports most of empirical psychology, is the area of psychometrics. Psychometrics is psychology’s proudest achievement, and perhaps the only body of knowledge unique to it. As with CBT, however, its epistemological base is as dubious as the uses to which it is put.

Psychology & Science: Reflections on a Discipline in Crisis

What is visible within a science, the sorts of statements it can make and encompass, the discursive strategies it deploys – these are all contingent upon some prior condition, at least, according to a disparate range of modern philosophers. For Heidegger, Gestell (enframing) provides the precondition for something to be made present. For Foucault, drawing from the latter, an episteme is the condition of possibility of knowledge. In Kuhn’s philosophy of science, paradigms provide the boundaries within which ‘normal science’ can occur, and Wittgenstein wrote of the rules of language games.

Whilst these concepts are not straightforwardly equivalent, what they share is the idea that there are a priori assumptions that precede scientific research, and that the products of such research will be contingent upon these assumptions in various ways. The assumptions ordain in advance what can be seen, and what can be said, and what simply makes no sense within a given perspective. This point seems to be forgotten by those who are most enthusiastic about the notion of psychology as a ‘science’ (as opposed to say, psychology as a branch of metaphysics, or as a subset of psychoanalysis).

What psychology makes visible, and what it articulates, within its particular framework, is principally devoted to the statistical study of hypothetical constructs (diagnoses, ‘traits’, states, ‘behaviours’, etc). What is rendered invisible, or unsayable in this approach? First, and most obviously there is no proper consideration of ontology, no thorough or coherent analysis of the sort of being to whom one is appending all these statistical artifices. Secondly, there is a refusal of the qualitative dimensions of empiricism, as if anything that cannot be assigned a number is essentially non-existent. Thirdly, there is very largely a repudiation of the social and linguistic dimensions of human life – despite their conceptual contiguity, sociology, history and linguistic perspectives are sidelined in an Anglophone psychology that is fundamentally atomistic, with socio-linguistic ‘’factors’ tacked on as a kind of ontological afterthought. This accounts, for instance, for the ludicrous lengthiness of the tired nature-nurture debacle, as if something like human ‘nature’ could wander about unmediated by social bonds, laws and language. No such nature exists, except, perhaps, in mythology, yet to question these untenable assumptions, or others (‘temperament’ comes to mind, as does the notion of ‘cognition’) is to situate oneself outside of respectable scientific discourse, as currently conceived. There are the two options from which to choose, it seems to me – either a narrow, quantitative, pettyfogging ‘science’ of psychology, that ignores the most vital aspects of human life in pursuit of concepts that are as degraded as they are ridiculous; or, something altogether different to science itself, but which replaces rigour with statistical fetishism.

Of course, within a science (or paradigm, or framework) like psychology, there can only ever be a limited contest of ideas. Mostly, there is a contest of power, more or less independent of ideas. Authorities determine what is scientific or ‘evidenced-based’. To dare to observe flaws in the ‘science’ of psychology is to risk accusations of unprofessionalism or scientific nihilism. Students and would-be practitioners must obey their masters if they want a Masters.

And these issues are not merely theoretical. If an entire discipline construes human subjects as mere bundles of data, from which ‘information’ is to be extracted as efficiently as possible, one might expect this to be reflected in clinical practice, and it is (often). The individuals, institutions and systems that treatment people thus can regard themselves ‘scientific’.

On the Passage from the ‘Structuralist’ to the Later Lacan

In discussion with certain colleagues in recent times, I thought it useful to reflect on Lacan’s shift from a ’structuralist’ psychoanalysis rooted in linguistics (in the 1950s) to his ‘late’ work, which I figure to date from around the time of Seminars XVI and XVII. (Structuralism is in quotes here as Lacan, for his part, denied being a structuralist per se). To put it very schematically, there are several reasons why I believe Lacan moved away from the clinic of the 1950s, with its language derived from Saussure and Jakobson, to his later period. I present some of these reasons here, without claiming that the list is any way exhaustive: